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Acalculous cholecystitis after aortic reconstruction

R T Hagino1, R J Valentine, G P Clagett

  • 1Department of Surgery, University of Texas Southwestern Medical School, Dallas, USA.

Journal of the American College of Surgeons
|March 1, 1997
PubMed
Summary
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Acute acalculous cholecystitis is a rare but dangerous complication following aortic surgery. Early diagnosis and intervention are crucial, as mortality remains high even with prompt treatment.

Area of Science:

  • Vascular Surgery
  • Gastrointestinal Surgery
  • Surgical Complications

Background:

  • Acute acalculous cholecystitis (AAC) is an uncommon but serious complication in patients undergoing aortic surgery.
  • This condition carries a significantly high mortality rate, particularly in patients with pre-existing comorbidities common in aortic surgery candidates.

Purpose of the Study:

  • To determine the prevalence, patient demographics, surgical details, and outcomes of patients who develop AAC post-aortic reconstruction.
  • To highlight the diagnostic challenges and management strategies for this rare complication.

Main Methods:

  • Retrospective review of patient charts from the past 10 years.
  • Analysis of 7 patients who developed AAC after undergoing aortic reconstruction.

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Main Results:

  • Seven out of 996 patients developed AAC post-aortic reconstruction, predominantly nondiabetic men (mean age 66).
  • Common factors included prior aortic operations, prolonged intraoperative hypotension, and increased transfusion needs, leading to multiorgan dysfunction.
  • Symptoms appeared a mean of 32 days post-operation; diagnosis was challenging, with 71% overall mortality.

Conclusions:

  • AAC is the most frequent postoperative biliary complication after aortic surgery.
  • Clinical suspicion is vital in patients with abdominal sepsis signs post-aortic surgery, especially with complex recoveries.
  • High mortality persists despite early diagnosis and intervention.